Robert Wood Johnson-funded program will focus on innovative Medicaid value-based contracting
NEWARK, Del.–(BUSINESS WIRE)–#AmeriHealthCaritas—AmeriHealth Caritas Delaware, a Medicaid managed care health plan serving Delawareans using Medicaid and long-term services and supports, is partnering with Nemours/Alfred I. duPont Hospital for Children and the state’s Division of Medicaid and Medical Assistance to participate in a national program that will assess the effectiveness of using payment innovations to reduce and eliminate disparities in health and health care.
The national program, Advancing Health Equity: Leading Care, Payment, and Systems Transformation, will determine effective ways to align and leverage payment and quality improvement activities to improve health equity. The program, funded by the Robert Wood Johnson Foundation, will also review innovative Medicaid payment and contracting models as a strategy to reduce health disparities.
The Center for Health Care Strategies (CHCS) has worked with the University of Chicago and the Institute for Medicaid Innovation to create teams comprised of state Medicaid directors, Medicaid managed care organizations (MCOs), and clinical partners to pursue payment innovations that support health equity. Delaware was one of only seven states selected to participate, and AmeriHealth Caritas Delaware was chosen to be the MCO to join the Delaware Division of Medicaid and Medical Assistance and Nemours/duPont Hospital for Children to represent the Diamond State. The other participating states are: Pennsylvania, New Jersey, Illinois, Maine, Tennessee and Washington.
“We are honored to represent Delaware in this very important learning collaborative,” said AmeriHealth Caritas Delaware Market President Emmilyn Lawson. “Since our inception, we have worked tirelessly with our health care providers to develop value-based payment models that encourage innovation to meet the needs of patients while achieving cost-efficient care.”
One of the goals of the program is to increase the readiness of state Medicaid directors, MCOs, and provider organizations to successfully align payment and delivery system reforms to achieve health equity by creating and disseminating tools, resources, and training processes.
Dr. Lenaye Lawyer, AmeriHealth Caritas Delaware Market Chief Medical Officer, said the MCO’s value-based agreements align with its mission to address the social, economic and environmental barriers that may prevent its members from obtaining and maintaining good health.
“Our agreements provide opportunities for PCPs, community health workers and case managers to deliver whole-person care which is essential in keeping patients healthy,” Dr. Lawyer said. “Each agreement provides the flexibility that our health care providers need to address both medical and non-medical health care needs of our members.”
Nemours/Alfred I. duPont Hospital for Children has worked with payers for several years to align payment to value-based payment models and has made significant investments in people, processes and technology to support the achievement of such contracts.
“We look forward to progressing our value-based payment models to incorporate health disparities and social determinants of health with a focus on pediatrics,” said Jamie Clarke, Executive Director of Value-Based Care for Nemours. “This program provides a unique opportunity to align on a common goal to advance health equity, share learnings amongst the seven teams and then spread to others nationally.”
In addition to the learning collaborative, Advancing Health Equity will provide tailored equity-focused technical assistance to state Medicaid agencies and coordinate a national advisory and policy development committee. The committee of national experts in health disparities, consumer and patient perspectives, state Medicaid programs, Medicaid MCOs, and providers will identify implementation lessons and develop policy recommendations for broad dissemination to other state Medicaid programs, health plans, providers, and policymakers.
“Our Division of Medicaid and Medical Assistance is pleased to work with and support innovative providers and payers like Nemours and AmeriHealth Caritas Delaware who make eliminating health disparities part of their missions,” said Department of Health and Social Services Secretary Dr. Kara Odom Walker, a practicing family physician. “We look forward to collaborating with and learning from our partners in this project.”
About AmeriHealth Caritas Delaware
AmeriHealth Caritas Delaware, part of the AmeriHealth Caritas Family of Companies, is one of the Medicaid managed care plans that participate in the Diamond State Health Plan and Diamond State Health Plan-Plus programs. AmeriHealth Caritas Delaware helps Delawareans get proper care and stay well, working with communities in need to achieve positive health outcomes throughout the state. For more information, visit www.amerihealthcaritasde.com.
About AmeriHealth Caritas
AmeriHealth Caritas is one of the nation’s leaders in health care solutions for those most in need. Operating in 12 states and the District of Columbia, AmeriHealth Caritas serves more than 5 million Medicaid, Medicare and Children’s Health Insurance Program (CHIP) members through its integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, and behavioral health services. Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 35 years of experience serving low-income and chronically ill populations. AmeriHealth Caritas is part of the Independence Health Group in partnership with Blue Cross Blue Shield of Michigan. For more information, visit www.amerihealthcaritas.com.